Hello, Doc? With Telemedicine, Medical Help Is Just a Phone Call Away

Something as simple as instructing employees to pick up the phone has saved Rent-A-Center more than $750,000 in health care costs in just 16 months.

The company, based in Plano, Texas, began offering employees access to telemedicine as part of its health insurance coverage last year, helping to slash the excessive use of emergency room visits for the delivery of routine medical care.

Company executives wanted to know, "What tool can we offer [employees] that can get them the care they need that works for their time schedule in a way that is friendly to their wallet," says ALeta Dover, global benefits manager.

Rent-A-Center, which allows customers to rent to own furniture, appliances and other big-ticket items, signed up with Teladoc Inc., which provides medical consultations over the phone. Depending on the diagnosis, Teladoc physicians might call in a prescription for antibiotics, tell a person to call 911 and more.

Workplace telemedicine is a slowly growing trend, but one that is gaining increasing attention.

Just 5 percent of companies with at least 5,000 employees offered telemedicine in 2010, the 2011 National Survey of Employer-Sponsored Health Plans from the New York-based consultancy Mercer shows. By 2011, that percentage had jumped to 11 percent, and 38 percent more said they were interested in offering the service. More than 2,800 employers took part in the survey.

Employers are interested in the option for a variety of reasons, says Bruce Hochstadt, a physician and a partner at Mercer. Not only is a telemedicine consultation less costly than a visit to a doctor's office, but also an employee doesn't have to leave the workplace, travel to the office, then wait around to be seen, Hochstadt says.

And in places with physician shortages, it can provide more timely access to care, he says. That can mean "earlier detection of a condition when it might be less advanced and less costly to treat."

Most often, telemedicine is used to treat conditions such as the flu, upper-respiratory infections, urinary tract infections and allergies, says Jason Gorevic, CEO of Teladoc, which has corporate offices in Dallas and Greenwich, Conn.

Because telemedicine consultations are generally available around the clock, they address "the challenge people have in getting access to quality primary care 24 hours a day, seven days a week," Gorevic says. "People frequently end up in the emergency room or urgent care center, or they forgo care."

About one-third of Teladoc's physicians are semiretired, one-third are emergency room doctors who have spare time to consult with patients remotely, and one-third have a primary care practice, Gorevic says.

Having access to telemedicine doesn't mean the end of visits to the doctor. "It doesn't replace the times you need to see a doctor or you need to go to a hospital," says Jonathan Linkous, CEO of the American Telemedicine Association.

Dover recalls the case of one Rent-A-Center employee who hadn't felt well for a week, but didn't want to take time off work. One evening he called Teladoc and was told to immediately head to the emergency room because he was in the beginning stages of a heart attack. The diagnosis was confirmed in the ER, and the employee was told he likely would have suffered a massive heart attack within 24 hours.

Dover still chokes up recounting the story of one employee who declined to make that call to Teladoc and was found dead at home 36 hours later after suffering a heart attack. "It happened about a year ago and it still bothers me," Dover says.

One stumbling block is that physicians are licensed on a state-by-state basis, so a doctor treating someone in California must be licensed there.

Congress recently allowed doctors licensed in one state to treat military members and veterans regardless of the state they're in, and Linkous hopes that will eventually carry over to telemedicine providers.

Office furniture dealer Goodmans Interior Structures, based in Phoenix, began using telemedicine services this year provided by MeMD of Scottsdale, Arizona, says human resources director Brian Turner. "We want our employees to be in the driver's seat in taking care of themselves."

The company has about 150 employees in Arizona and New Mexico. Employees can either use a kiosk at the workplace, or a computer with a webcam from home or another location to connect with MeMD's physicians.

Kiosks are equipped with a scale, a blood pressure monitor and a thermometer, so patients can take measurements and provide the information to the doctor. A traditional office visit costs an employee $40, but Goodmans Interior Structures helps subsidize the cost of MeMD and employees pay $35 per consultation. It's too early to determine the financial effect, but Turner says he expects a small savings.

Rent-A-Center introduced telemedicine to its employees Jan. 1, 2011, and in the first 16 months saved more than $777,000 in visits to emergency rooms, primary care doctors, urgent care centers and specialists, as well as in productivity that would have been lost, officials say.

The company has more than 12,000 employees in its health plan, plus dependents, and employees pay an extra $1.50 a month for telemedicine coverage.

A Teladoc consultation is free, compared with a $20 copay to visit a primary care physician. The patient benefits financially and the company benefits, particularly because each of its stores has only five employees. An employee's absence can have a major effect on other workers. Typically, the quicker the treatment, the quicker the cure, says global benefits manager Dover, who has had her own experiences using Teladoc.

In one case she left work early with a bad cough. Her primary care physician could see her at 10 a.m. the next day. She called Teladoc and had a prescription by 6 p.m. the same day. "I was on the road to recovery by 10 o'clock the next morning, when my doctor would have started seeing me."